4 & 5 jaw relation 1 & 2

4 & 5 jaw relation 1 & 2

2. Recording edentulous Jaw
Relationships
(Principles of registration of
maxillomandibular relationships)

3. Accuratedetermination,recordingandtransfer
ofJawRelationfromtheedentulouspatientto
thearticulatorisessentialfortherestorationof
Function,Facialappearance,andthe
maintenanceofthepatient’sHealth.
Unsatisfactorymaxillomandibularrelationships
willeventuallyleadtofailureofcomplete
denture.

4. Jaw relation ?:
Any positional relationship of the mandible to the
maxilla

5. Steps of Jaw Relation Record:
I-Check the record blocks (base plates) as regard : Extension,
Retention, and Stability .
II-Adjustment of The Occlusion Rim as regard :
Facial contour, Height, and Orientation of the Occlusal plane.
III-Recording Certain Guide lines :
Central line, High lip line, and canine lines.
IV-Determination of the Vertical Dimensions.
V-Recording of the Horizontal Jaw Relations. Centric J. R. &
Eccentric J. R. (depending on the design of the articulator).
VI-Face-Bow Record (Orientation Relation).

7. Record Bases (Baseplates)
and Occlusion Rims
Used to relate casts on
an articulator
Record bases simulate
the finished denture
base
Wax occlusion
rims simulate the
position of the
teeth

8. 1.Checkocclusionblocks.
Thebordersoftherecordbasesshouldbesmooth,
roundedandpolishedtoprovidemaximum
patientcomfort,toavoidirritationandtensionof
thepatient,whichmyleadtofalserecord

9. Check occlusion blocks
Extension
Stability
Retention

10. Facial contour depends on the presence and
alignment of teeth. With the loss of teeth, lips
&cheeks loose their support resulting in senile
appearance.
Occlusionrimsshouldbeadjustedtorestore
lip&cheeksupport,soastorestorethenormal
facialcontour&appearance
II-Adjustment of The Occlusion Rim

11. II-Adjustment of The Occlusion Rim as regard :
1-Facial contours: -----Pleasing facial appearance
The following land marks are used as a guide
•Fullness of the upper lip.
•The philtrum
•The nasolabialfold
•The corner of the mouth

13. Maxillary Occlusion Rim
Adjustment
Lips should be unstrained
•Naso-labial angle ≈ 90°
•Philtrum depressed
•Vermilion border showing

14. Thelabialsurfaceoftheocclusionrimisadjusted
byremovaloradditionofwaxuntilnatural
appearanceandapleasingpositionoftheupper
lipsisobtained.

15. II-Adjustment of The Occlusion Rim as regard :
2-Height of the occlusal plane :
-The plane of occlusion maybe defined as an
Imaginary plane, which contacts the incisal&
occlusal surfaces of the teeth.
1-2 mm below the upper lip in normal lip length
patient when relaxed

16. The upper occlusion rim is adjusted so that its
lower border is 1-2mm below the lip while at rest.
Normally, 1-2mm of the anterior teeth will be
showing below the upper lip.

17. Maxillary Occlusion Rim
Adjustment
Touches wet line
of lower lip when
‘F’ or ‘V’ sounds
Count ‘50-60’

18. Use a Hot Wax
Former

19. Mandibular Occlusion Rim
Adjustment
Posteriorly, the occlusion
rim intersects 1/2 -2/3 up
the retromolar pad

20. Mandibular Occlusion Rim
Adjustment
Anterior height
even with the
corners of the
mouth when the lip
is relaxed

21. II-Adjustment of The Occlusion Rim as regard:
3-Orientation of the occlusal plane:
Anterior plane // to interpupillaryline
Posterior plane // to Ala tragus line( Comper’sline)
Fox plane

22. III-Recording Guide lines :
Central line, High lip line, and canine lines.

23. The midline
The Canine lines
The High lip line
For proper & correct setting-up & arrangement
of teeth, certain guide lines are drawn on the
occlusion rims.

26. IV-Determination of the Vertical Dimensions:
Vertical relation determine the amount of
separation between the two jaws and has to be
established correctly for the proper comfort,
health, and function of the mouth.
It is the distance between two selected anatomic or
marked points usually one on the tip of the nose
and the other upon the chin
( fixed and movable members)

27. Determining the vertical
dimension will aid in
determining the amount of
space available between the
maxillary & mandibular
arches; that will later be
occupied by the upper &
lower dentures.

28. 2Types:
Vertical dimension of rest (VDR):
When the mandible in rest position(after talking, swallowing, or
chewing) , the person is relaxed and the teeth are separated by a gap
( the elevator and depressor muscles of the mandible are in
equilibrium
It can be considered a constant and reproducible position, but may
be subjected to some variables
Vertical dimension of occlusion (VDO):
When the teeth or occluding rims are in maximum occlusal contact

29. V D R
V D O

30. It is the difference between V.D.R & V.D.O.
It has an average of 2-4mm.
Space between wax rims at
physiologic rest position

31. Biological importance of correct
registerationof VDO, the patient
can:dimension; the patient can
1 -Masticate his food efficiently.
2 -Speak without impediment.
3 -Present a normal facial appearance.
4 -Experience a minimum amount of
discomfort in using his dentures.

32. Methods of determination of occlusal vertical
dimension in edentulous patient:
1-Pre extraction records:
-Radiograph
-Profile photograph
-Contoured wire profile
-Facial measurements
-Plaster casts of the dentulous condition
-Face mask

33. Methods of determination of occlusal vertical
dimension in edentulous patient:
2-functional performance methods ( Physiologic) :
-Respiratory (physiologic) rest position
-Phonetics of some labial sound (m m), Closest speaking
space(The space between the occlusal surfaces and incisaledges of the teeth
When the mandible is elevated to the maximum extent during speech ), it is a
dynamic measurement recorded during physiologic function of speech ( Free
way space: resting measurements )
-Let the patient swallow and then relax or wet his lip with
the tip of the tongue then relax
-Swallowing for evaluation of V D

34. Methods of determination of occlusal vertical
dimension in edentulous patient:
3-Esthetic methods : Study of the harmony of the
facial proportions:
The lips should provide pleasing and normal appearance,
angle of the mouth.
4-Ridge relationships:
Upper and lower posterior ridges should be parallel to each
other ( evaluation of V D )
5-Boos Bimeter:
The biting force is maximum at the correct separation of the
two jaws

35. Methods of determination of occlusal vertical
dimension in edentulous patient:
6-Several measurments:
-Willis device
7-Dimensions by photograph (Wright relative
measument)

36. Effect of wrong registration of VDO:
Low VDO
1-inefficiency
2-cheek biting
3-appearance
4-soreness of the
corner of the mouth
5-pain in TMJ
6-lack of tongue
space
High VDO
1-discomfort.
2-trauma and
soreness and rapid
resorptionof alveolar
bone
3-loss of free way
space
4-clicking of teeth
during speech
5-appearance
(elongated face)
6-difficulty in
swallowing

37. Patient sitting upright
Soft tissue position affected by posture

39. Clinical procedures:
NB. Ensure equalizing the pressure of
occluding forces by even contact between the
upper and lower occlusion blocks .

40. V-Recording the Horizontal Jaw Relations:
-Centric J. R.
-Eccentric J. R.
-Protrusive relation
-Lateral relations:
* Left lateral
* Right lateral

41. CENTRIC RELATION
The most retruded relation of
the mandible to the maxillae when
the condyles are in their most
posterior unstrained position in
the glenoidfossae.

42. Centric Relation:
-It is a bone to bone relation that is reproducible. It remains
constant throughout life & during its recording cuspal relation of
the teeth is not considered.
-Serve as a reference point for establishing denture occlusion for
edentulous patient
-To provide harmonious balanced occlusal contact between
teeth during function

43. CENTRIC OCCLUSION
The occlusion of opposing teeth when
the mandible is in centric relation.
-if C R & C O in artificial teeth not
coincide the stability of the denture
decreased and the patient will subjected
to unnecessary pain or discomfort

44. Significance of centric relation:
It is important to establish a repeatable and
recordable reference positionfor construction of
occlusion in complete denture, Failure of
construction of occlusion in centric relation will
lead to trauma to denture foundation and TMJ and
affect greatly the stability and the efficiency of the
dentures as well as the comfort of the patient

45. Significance of centric relation:
1-CR is a guided, retruded posterior border position
rather than habitual position presented by the patient
it is bone to bone relation which in the healthy patient
can be considered constant for clinical purposes.
2-it is repeatable, recordable and is the point of
reference for establishing centric occlusion

46. Significance of centric relation:
3-when centric relation and centric occlusion do not
coincide or freedom in centric not present the stability
of the denture will be impaired ….pain and discomfort
4-edentulous patient use the centric relation closure
in mastication and other mandibularactivities as
swallowing . CR is the position at which masticatory
cycle is started and ended.

47. Methods of determination
of centric relation
1-Wax registration method (check
bites).
2-Terminal hinge axis determination
method (Kinematic face bow).
3-Graphic tracing or excursive
method.
4-Chew in or functional record
method.

48. Wax registration
method
=
Check bites
=
Wax wafer method

49. 1-Wax registration method (check bite method):
It is the most commonly used method, ( easy , not time
consuming, no need for complicated instrument or
device)
This procedure make use of a suitable wax interposed
between occlusion rims at the previously determined
occlusal vertical dimension

50. Wax Registration Method

56. Methods used to guide the mandible in centric
relation:
1-Tongue retrusionmethod.
2-Swallowing method
3-Fatigue method
4-Relaxation
5-Biting operators fingers
6-Head position.
7-Temporalismuscle check.

57. Difficulties of retrudingthe mandible:
1-in patient who have had edentulous posterior areas for
long duration without replacement
2-in patient who have lost the occlusal relations of old
dentures due to a closure of the occlusal V D
3-in patient who have been fully edentulous for a long
period.
4-in patient who are tense and not relaxed at the time of
recording centric relation.

58. 1-Wax registration method (check bite method):
The record should be checked for:
1-the wax rims should be the only contacting surfaces.
2-the trial denture bases should fit exactly on their casts
without rocking to be sure that no warpage has occurred
3-any contact between the upper and lower casts at the
rear should be eliminated as it would prevent the
occlusion blocks from being accurately seated

59. 2-Terminal hinge axis method
Kinematic Face Bow
( Mandibular Face Bow )
The Kinematic face-bow is
attached to the mandible that is
why it is sometimes called the
mandibular face-bow.

60. 3-Excursive methods
or
Graphic tracing method

61. 3-Graphic tracing methods:
This technique shows the horizontal movement of the mandible in
the form of a tracing, made by a pointed attachment fitted to one
block , on a recording plate fitted to the other block.
2 types : intra oral tracers and extra oral tracers

62. 3-Graphic tracing methods:

63. 3-Graphic tracing methods:

64. 3-Graphic tracing methods:

65. GraphicTracing Method

66. 4-chew in-or functional record methods:
a)Needles House’s chew in technique:
a)Essingand Paterson’s chew in technique:

67. Eccentric Jaw Relationships
Protrusive Record
Right Lateral Record
Left Lateral Record
Any jaw relation other than centric relation .

68. ECCENTRIC JAW RELATIONS
Methods of Registration:
1.Wax registration method.
2.Graphic tracing method.
3.Chew –in or Functional method.

69. Christensen Phenomena
When the mandible moves forward to an edge to edge position , separation
occurs distally between the natural dentition or occlusion rims .
Significance:
-Steepness of the condylar path
-Horizontal condylar path inclination in the articulator
-Protrusive Record

71. 5-face bow record
Orientation relation

72. FACE-BOW
•The face-bow is a caliper-like device that
is used to record the relationship of the
jaws to the tempromandibularjoint or (
opening axis of the jaws ) and to orient
the casts in this same relationship to the
opening axis of the articulator.
•The face-bow transfer ensures that the
casts are mounted centrally in correct
relation to the inter-condylar axis and to the
centers of lateral movements.

74. TYPES OF FACE-BOWS
1-Mandibular or kinematic face-bow (
hinge axis face-bow ).
2-Maxillary face-bow (arbitrary face-bow).

75. 1.To locate the exact terminal hinge axis
(rotational axis) for subsequent use of
maxillary face-bow
bow-Uses of Mandibular Face
2. To record the centric relation.

76. Terminal Hinge Axis Method

77. Uses of Maxillary Face-bow
This relates the maxilla to the exact
or arbitrary position of the condylar axis
and transfers this relationship to the
articulator.